By Reyna Revelle for WISH-TV.
Broadcast version by Joe Ulery for Indiana News Service reporting for the WISH-TV-Free Press Indiana-Public News Service Collaboration
Health care providers recognize the need to ensure accessible, culturally competent mental health support, especially with the growing diversity in central Indiana and the resources available to those in crisis.
Dr. Sally Fleming, a clinical psychologist at Riley's Children's Hospital at IU Health, told News 8, "It is a real issue here in our home state of Indiana. We see it daily. But, it's throughout our state for all ages. It's not just the kids, it's everyone, and the numbers are not decreasing."
IU Health has made strides to expand its suicide prevention programs. Its health care providers have been training staff on the best practices for supporting others from diverse backgrounds. They have worked to reach underserved groups and destigmatize conversations around mental health.
Fleming said, "Suicide rates are higher. Suicidal ideation.. these things are higher in our population of more diverse ethnic groups, and we have to be aware of that as clinicians and ask the right questions."
The clinical psychologist says the stress of coming to a new country combined with disparities in socioeconomic status are complex factors that can profoundly affect mental health and suicide risk. Prioritizing mental well-being is taught through support groups, education, and action.
"One program I'm involved in is the Collaborative Assessment Management of Suicidality. It is suicide-specific and held at Riley hospital. This is primarily for our teenagers who have experienced suicidal ideation and attempts."
The U.S. Centers for Disease Control and Prevention reports suicide is the second-leading cause of death for Hoosiers from the ages of 14 to 39. It also says, in the past year, 5% of Hoosier adults and 11.1% of young adults from the ages of 18 to 25 have experienced suicidal thoughts.
Jason Craig, director of the Indiana Suicide Prevention Network, said, "Suicide affects anybody and everybody. There is no discrimination to suicide or thoughts of suicide. Bringing awareness to things like the 988 line; they have interpreters available significant for all walks of life."
A recent study shows that the majority of adults believe that suicide can be prevented, and 96% of adults in the U.S. would act if someone close to them were thinking about suicide.
"You can be that shining light of hope for somebody by asking how you are doing and being sincere with that ask," Craig said.
Reyna Revelle wrote this article for WISH-TV.
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Sen. Richard Blumenthal, D-Conn., is introducing federal legislation to boost mental health equity.
The Pursuing Equity in Mental Health Act allocates $995 million in grant funding over five years for states to use to reduce disparities in mental health care, which comes as a new report showed Connecticut teen suicides doubled from this time last year.
Janelle Posey-Green, founder of the Connecticut BIPOC Mental Health and Wellness Initiative, said teens need more education on the language of mental health.
"I really think we need is more education on what to look for so that way friends can check in on friends and they know the warning signs and even have, maybe, a script or a narrative that they can go to," Posey-Green suggested. "Let's normalize that at some point you may feel depressed."
She recommended it should be done through a community initiative involving schools and parents. Aside from the bill's funding, Connecticut is receiving more than $4 million from the Health Resources and Services Administration to expand mental and behavioral health, and substance use disorder services.
However, disparities in care are not the only thing preventing people from accessing mental health care. Studies show women of color are at higher risk for mental health issues but are less likely to seek treatment.
Posey-Green observed as much as the Black community can lift people up, things such as "strong Black woman syndrome" can hold women of color back from talking about their mental health.
"Where does this woman who is expected to be so strong get the opportunity to talk about how hard it is that from childhood to adulthood she's faced with many microaggressions and major aggressions over her life period that impact her mental health?" Posey-Green asked.
Other issues such as cultural differences can pose a challenge. Posey-Green works with a collective of providers for patients to access mental health professionals with similar backgrounds. She argued providers should be trained in cultural humility rather than cultural competency.
"Why it's important for providers to lean towards cultural humility and be trained well with understanding how cultural humility can help with providing better service is because it also teaches you to check your unconscious biases," Posey-Green stressed.
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A 2024 study showed almost 26% of Nebraskans reported having a mental-health illness in the past year -- nearly 3% higher than the national average.
Providers and stakeholders of Nebraska's behavioral health care system face uncertainty as more budget cuts loom. In the last legislative session, $15 million was cut from the state's behavioral health services budget and the heads of state government divisions are now being asked to find more cuts.
Tiffany Gressley, regional administrator for Region 3 Behavioral Health Services, questioned how cuts to behavioral health align with Nebraska's conservative values.
"We're being fiscally conservative by serving these people early; as early as we can," Gressley pointed out. "We're saving money and we're saving, on top of that, the human cost that goes along with untreated mental health conditions. "
Gressley explained last year's cut brought the total budget reductions to Nebraska's behavioral health system to nearly $50 million over the past six years, much of it from unfunded provider rate increases. She stressed budget cuts mean fewer Nebraskans receive services.
Among Nebraska counties, 88 of 93 had a shortage of behavioral health providers in 2023, and 29 had none at all. Many rural Nebraskans face considerable challenges accessing behavioral health care, which advocates said further budget cuts will only exacerbate.
Sadie Thompson, chief innovation officer for the Lincoln-based Wellbeing Initiative, an organization providing services for mental health, substance use and chronic physical health conditions, said after a nearly 12% cut to its budget this fiscal year, the organization had to close satellite locations in Fairbury and Geneva and was unable to open one planned for Seward.
"All of these rural communities that we were really starting to see lots of engagement with and impact basically got the rug pulled out and weren't able to continue to have these services," Thompson noted. "These communities don't have services anyway."
Bob Shueey, CEO of South Central Behavioral Services in Hastings and Kearney, said they are constantly looking for qualified therapists and frequently have to turn patients away as a result. Shueey added the state's low provider rate combined with retirements has depleted the state's behavioral health workforce. He argued without attention, the situation will only worsen.
"Even if we raise the rates to a sustainable rate today, it's a multiyear pipeline before someone's even able to start working," Shueey emphasized. "Then that information has to be out there to new students and to young people. 'I'll be able to make my house payment and pay my student loans if I do this; I'm not going to be poor my whole life.'"
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One in four Californians is an immigrant and a new report showed many are refugees who may need mental health services but have trouble finding treatment.
Researchers from the California Pan-Ethnic Health Network found a pressing need for culturally-responsive behavioral health services.
Vincent Chou, community advocacy manager for the group, said many barriers can hinder access.
"These communities face distinct challenges such as trauma from displacement, stress, language barriers, and systemic discrimination," Chou outlined. "All of which contribute to why they're not really utilizing the mental health services that are available to them."
Community groups said they have seen a huge increase in demand for mental health services since the pandemic. The report also called for training on trauma-informed care for providers and county workers who assist immigrants.
Mary Anne Foo, executive director of the Orange County Asian and Pacific Islander Community Alliance, said California faces a dire shortage of bilingual, bicultural mental health providers; people who can better connect with patients.
"When they see a counselor who can speak their language, they're more apt to be able to describe what's going on with them," Foo pointed out. "Or to be able to participate fully in their care."
Ruqayya Ahmad, policy manager for the network, said the state needs to better fund community-based organizations so they can recruit mental health professionals from the populations they serve and offer competitive pay to retain them.
"They're the ones who have these trusted relationships," Ahmad emphasized. "They're helping to normalize mental health conversations and reducing that stigma that exists in some communities."
Vattana Peong, executive director of The Cambodian Family Community Center in Santa Ana, said the state also needs to make it easier for groups like his to get credentialed to accept Medi-Cal insurance.
"There are a lot of barriers for community-based organizations who want to become Medi-Cal mental health providers," Peong stressed. "That is something we need to fix."
He added community groups often offer wraparound services, like child care and transportation, making it easier for low-income families to access health services.
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